ABSTRACT
Background Older age and inappropriate prescribing is related to a greater rate of emergency department visits and hospitalisations. Objective To assess the efficacy of an interprofessional collaboration programme in which a review of the medication of older patients seen in the emergency observation unit was carried out. Setting Emergency departments at four Spanish hospitals. Method Randomised, controlled study. Patients over 65 years of age presenting to the emergency department were randomised to a control or an intervention group. In the intervention group, a pharmacist reviewed the patients' chronic medication and identified any potentially inappropriate prescriptions based on the STOPP/START criteria. Each case was discussed with the emergency specialist and a recommendation to modify the treatment was sent to the general practitioner. Main outcome measure Rate of emergency visits and hospital admissions. Results The adjusted rate ratio of emergency visits and hospital admissions was 0.808 (95% CI 0.617 to 1.059) at 3 months, 0.888 (95% CI 0.696 to 1.134) at 6 months and 0.954 (95% CI 0.772 to 1.179) at 12 months. There was a statistically significant reduction at 3 months in two of the hospitals that participated in the study [adjusted rate ratio at 3 months was 0.452 (95% CI 0.222 to 0.923) in hospital 3 and 0.567 (95% CI 0.328 to 0.983) in hospital 4]. Conclusion Overall, the intervention did not reduce the number of emergency visits and hospital admissions. However, a significant effect was observed in centres were a high acceptance rate of treatment recommendations was achieved.
Subject(s)
Drug Utilization Review/trends , Drug-Related Side Effects and Adverse Reactions/prevention & control , Emergency Service, Hospital/trends , Inappropriate Prescribing/trends , Medication Reconciliation/trends , Pharmacists/trends , Aged , Aged, 80 and over , Drug Utilization Review/methods , Drug-Related Side Effects and Adverse Reactions/epidemiology , Female , Humans , Inappropriate Prescribing/prevention & control , Male , Medication Reconciliation/methods , Spain/epidemiology , Treatment OutcomeABSTRACT
INTRODUCTION: The objective of this study is to analyse the appropriateness and characteristics of drug dose calculation for hospitalised, morbidly obese patients. METHODS: Retrospective, descriptive study of dose calculations for drugs prescribed to hospitalised, morbidly obese patients in a tertiary hospital in 2007. The recommendations prepared by the Pharmacy division are used as a standard. RESULTS: We included 62 patients. The mean number of medications prescribed per patient was 12.1 (4-39), and an average of 2.4 (1-10) are listed in the recommendations. A total of 135 drugs were prescribed. Dose calculations for 81 of the above (60 %) coincided with recommendations and 54 (40 %) did not; there were 51 cases of underdosing and three cases of overdosing. DISCUSSION: Improper dosing was detected for prescriptions in the systemic antibiotic and antithrombin drug groups, with underdosing being more common than overdosing.
Subject(s)
Drug Dosage Calculations , Obesity, Morbid/metabolism , Adult , Aged , Analgesics/administration & dosage , Anti-Bacterial Agents/administration & dosage , Body Mass Index , Drug Overdose , Female , Fibrinolytic Agents/administration & dosage , Humans , Inpatients , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Introducción: El objetivo del trabajo es analizar la adecuación de la dosificación de los fármacos en los pacientes hospitalizados con obesidad mórbida y sus características. Métodos: Estudio retrospectivo y descriptivo de la dosificación de los fármacos prescritos a los pacientes hospitalizados con obesidad mórbida en un hospital de tercer nivel durante el año 2007. Se ha utilizado como estándar las recomendaciones elaboradas por el servicio de farmacia. Resultados: Se incluyó a 62 pacientes. La media de las especialidades farmacéuticas prescritas por paciente fue 12,1 (4-39), y 2,4 (1-10) la de los fármacos incluidos en las recomendaciones, con un total de 135 especialidades prescritas. La dosificación de 81 (60 %) de ellas coincidía con las recomendaciones y 54 (40 %) no; en 51 casos fue por infradosificación y en 3, por sobredosificación. Discusión: Se detecta dosificación inadecuada de los fármacos prescritos de los grupos antibióticos sistémicos y antitrombóticos, con predominio de la infradosificación (AU)
Introduction: The objective of this study is to analyse the appropriateness and characteristics of drug dose calculation for hospitalised, morbidly obese patients. Methods: Retrospective, descriptive study of dose calculations for drugs prescribed to hospitalised, morbidly obese patients in a tertiary hospital in 2007. The recommendations prepared by the Pharmacy division are used as a standard. Results: We included 62 patients. The mean number of medications prescribed per patient was 12.1 (4-39), and an average of 2.4 (1-10) are listed in the recommendations. A total of 135 drugs were prescribed. Dose calculations for 81 of the above (60 %) coincided with recommendations and 54 (40 %) did not; there were 51 cases of underdosing and three cases of overdosing. Discussion: Improper dosing was detected for prescriptions in the systemic antibiotic and antithrombin drug groups, with underdosing being more common than overdosing (AU)
